Intraoraalikuvantamisen osaamisen kehittäminen Metropolia Ammattikorkeakoulun Suunhoidon opetusklinikalla

Opinnäytetyömme tarkoituksena oli kehittää suuhygienistiopiskelijoiden osaamista intraoraalikuvantamisessa Metropolia Ammattikorkeakoulun Suunhoidon opetusklinikalla. Tarve intraoraalikuvantamisen kehittämiselle vahvistui suuhygienistiopiskelijoille teettämämme alkukartoituskyselyn perusteella. Tämän vuoksi opinnäytetyömme tavoitteeksi muodostui intraoraalikuvantamisen oppaan tuottaminen. Opinnäytetyöprojektimme toteutettiin tutkimuksellisen kehittämistyön menetelmää mukaillen. Tuotimme intraoraalikuvantamisen oppaan ohella myös kuvantamispassin, jota voidaan käyttää oppimisen tukena Metropolia Ammattikorkekoulun Suunhoidon opetusklinikalla. Opas sisältää selkeän ohjeistuksen intraoraalikuvantamisen vaiheista. Toiminnallinen opinnäytetyömme linkittyi Metropolia Ammattikorkeakoulun koordinoimaan Evidence-Based Quality Assurance in Dental Digital Imaging -hankkeeseen, minkä vuoksi opas käännettiin myös englannin kielelle. Kirjoitimme opinnäytetyöstämme raportin lisäksi kaksi ammatillista artikkelia Suomen Suuhygienistiliitto SSHL ry:n jäsenlehteen ja Radiografian Tutkimusseura ry:n ja Suomen Röntgenhoitajaliitto ry:n julkaisemaan Radiografia-lehteen. Opas on saatavilla sähköisenä versiona Metropolia Ammattikorkeakoulun internetsivuilla sekä Theseus-tietokannassa opinnäytetyöraportin liitteenä. Opas on siten käytettävissä muuallakin kuin Metropolia Ammattikorkeakoulun Suunhoidon opetusklinikalla. Toivomme, että opasta hyödynnetään ja tarvittaessa jatkokehitetään tulevaisuudessa.The purpose of our final project was to develop the knowledge of dental hygienist students' in intraoral imaging in the Metropolia University of Applied Sciences' Teaching Clinic of Oral Health Care. The need for developing the knowledge in intraoral imaging was confirmed based on the initial mapping enquiry that was made to the dental hygienist students. This is why the purpose of our final project was to produce a guide for intraoral imaging. Our final project was carried out using a research development process' method. Beside the guide, we also produced an imaging passport which can be used to support learning intraoral imaging in the Metropolia University of Applied Sciences' Teaching Clinic of Oral Health Care. The guide has clear guidelines on intraoral imaging's steps. Our practice-based final project is linked to the Metropolia University of Applied Sciences' coordinated Evidence-based quality in dental imaging project. Therefore, the guide was also translated into English. Besides writing a report of our final project, we also wrote two professional articles to Finnish Federation of Dental Hygienists FFDH's newsletter and to Radiography Research Association and the Society of Radiographers in Finland’s published the Radiografia journal newsletter. The guide is available in an electronic version in the Metropolia University of Applied Sciences' websites and in the Theseus database as the final project's attachment. The guide can be used, therefore, elsewhere beside the Metropolia University of Applied Sciences' Teaching Clinic of Oral Health Care. We hope that the guide is useful and could be further developed in the future if there is need.Opinnäytetyön tekijät: Sini Anttila, Elina Dinh, Ella Günther, Hanna Hakala, Johanna Hollo, Pilvi Kare, Jenni Kauppinen, Miia Kontro, Niina Kurunsaari, Virve Kurvinen, Riina Kämäräinen, Hanna Laulajainen, Sini Leinonen, Karoliina Nironen, Nina Reittu, Susanna Sevón, Jenni Tahkoniemi, Sanna Tala, Saana Terä

Cabbage and fermented vegetables : From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19

Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT(1)R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT(1)R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.Peer reviewe

Nrf2-interacting nutrients and COVID-19 : time for research to develop adaptation strategies

There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPAR gamma:Peroxisome proliferator-activated receptor, NF kappa B: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2 alpha:Elongation initiation factor 2 alpha). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT(1)R axis (AT(1)R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity